This is an interesting article from yesterday's AHA news.
Regards, David Frenkel Business Development GEFEG USA Global Leader in Ecommerce Tools www.gefeg.com 425-260-5030 AHA urges HHS to require health plans to accept HIPAA claims AHA in a letter today urged HHS Secretary Tommy Thompson to adopt a rule or guidance requiring health plans to accept hospitals' claims compliant with the Health Insurance Portability and Accountability Act. According to the letter, one of the major administrative costs and sources of frustration facing hospitals is frequent claim payment delays, particularly by private payers. The final HIPAA regulation on electronic formats and code sets established national standards for electronic submission of claims, and makes clear that health plans are not permitted to require additional elements that deviate from those specified, the letter adds. Plans can be somewhat arbitrary in processing, leaving providers facing payment delays and engaged in "wasteful" resubmissions and reconciliation. The letter asks HHS to clarify that plans must accept HIPAA-compliant claims for contractual provisions with other entities covered under HIPAA and for state and federal prompt pay requirements. The letter will be at <http://www.aha.org>.
